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General NPI Number Information
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NPI Number | 1245663236
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Entity Type | Organization
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Legal Business Name | USA VEIN CLINICS OF NEW JERSEY LLC
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Dates
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Enumeration Date | 08/14/2013
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 766 SHREWSBURY AVE STE 300
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City | TINTON FALLS
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State | NJ
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Zip | 07724-3001
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Country | US
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Telephone | 847-593-8460
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Fax | 224-246-8042
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Provider Business Mailing Address
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Address Line | 304 WAINWRIGHT DR STE 120
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City | NORTHBROOK
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State | IL
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Zip | 60062-1919
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Country | US
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Telephone | 847-257-1244
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Fax | 224-246-8042
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHRISTOPHER MORRISON
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Credential | MD
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Telephone | 727-644-3038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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